Cosmetic injections are linked to spread of variant CJD and hepatitis

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Injection of "fillers" to plump up lips and smooth out wrinkles could spread infections such as variant CJD and hepatitis, the Government's chief medical officer warned yesterday.

Injection of "fillers" to plump up lips and smooth out wrinkles could spread infections such as variant CJD and hepatitis, the Government's chief medical officer warned yesterday.

"Aesthetic fillers" injected under the skin, popular with celebrities to counter sagging features, use material from animals, birds and human corpses, Sir Liam Donaldson said.

In a crackdown on rogue cosmetic surgery clinics, Sir Liam said: "We do have to look into the use of aesthetic fillers to establish if there is any risk of variant CJD, hepatitis and other blood-borne viruses. There is no evidence of outbreaks in relation to the use of products but this is something we need to look into."

One of the most heavily used materials is collagen, which may contain bovine material carrying a potential risk of infection with BSE. The singer Kylie Minogue was reported this week to have had injections of a filler to enhance her lips.

Many fillers fall outside any system of regulation because they use human tissue. There are an estimated 20,000 high street clinics offering cosmetic treatments from Botox injections, which paralyse muscles rather than fill out wrinkles and do not contain animal or human tissue, to facelifts with widely varying standards and varying skill of surgeons.

They are to be regulated by the Healthcare Commission, the independent watchdog, and subject to regular inspections from April next year.

Cosmetic treatments are the most rapidly growing area of private health care. The Healthcare Commission said there were more than 34,000 surgical procedures performed in 2003-04 but these do not include chemical peels, laser treatments and Botox injections.

Private clinics estimate demand for Botox injections doubled last year to almost 100,000 treatments. Sir Liam said Botox was a prescription drug which it was illegal to advertise and should be administered only by a doctor or nurse.

Sir Liam warned that organisers of Botox parties, where women are entertained with drinks in hotel rooms or people's homes, could face prosecution. He was responding to two reports from the Healthcare Commission and the Expert Group on the Regulation of Cosmetic Surgery which called for tougher controls. Simon Gillespie, head of operations at the Healthcare Commission, said registered cosmetic surgery clinics mostly met the necessary standards, especially the larger ones, but they numbered only a few hundred.

"We have concerns about the number of organisations that did not fall under the scope of regulations, such as those providing Botox, chemical peels and injectable fillers," he said.

Harry Cayton, the Government's national director for patients and the public, said a search of the internet would throw up more than 300,000 websites promoting cosmetic treatments or exposing what happens when it goes wrong.

The expert group made 20 recommendations for action in cosmetic surgery, covering operations such as breast enlargement, liposuction and nose jobs, as well as treatments including Botox and fillers. Professional bodies are to be asked to develop specialist training programmes for cosmetic surgeons "as a matter of urgency".

The British Association of Aesthetic Plastic Surgeons said some doctors were "misleading patients" about qualifications. Its president, Adam Searle, added: "Often, patients do not have enough information to make educated choices which leaves them vulnerable."

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